New to Diabetes: What’s Next? (Part 4)

This week concludes the “New to Diabetes” series that I’ve featured over the pastfewweeks. It’s a little like being in school, isn’t it? You know there’s a lot to learn and at times (or maybe most of the time), it can feel pretty overwhelming.

But just as you did in school, breaks things down into manageable chunks — learn a little bit at a time, and focus on those areas where you know you need the most help. So, for example, if eating isn’t an issue for you, but you keep forgetting to check your blood glucose, put your energies into finding ways to remind yourself to check.

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This week, there are two more areas that I’d like to focus on to help you better take care of your diabetes.

Moving more for better health
At Joslin Diabetes Center, we often talk about the “cornerstones” of diabetes management: healthy eating, medicine, and physical activity. Whether you call it exercise or physical activity doesn’t really matter. What DOES matter is that you make it a permanent fixture in your life. Have you done so already? Great! If not, think long and hard about how to make this a reality. In case you need a gentle reminder of why activity is so important, let me elaborate a bit. Physical activity:

• Lowers your blood glucose and A1C

• Helps your body use insulin better, whether you make your own or inject it

Need I go further? Who doesn’t want all of these things for themselves? The hard part for most people, though, is getting started. If it’s been ages since you rode a bike or took an aerobics class, it can be pretty intimidating to now be faced with Zumba classes, yoga, Pilates, spinning, or any number of unusual-sounding types of exercise.

The good thing about all of these, though, is that you have choices. You don’t have to sign up for a pricey health club membership that you’ll use maybe three times. You can do something in the privacy of your own home. Or, maybe combine your love of socializing with the desire to be more fit and sign up for a dance class or a walking club. You’re never too old or too heavy to move. Whatever you decide to try, make sure that your activity program includes the following:

Aerobic activity. This gives your heart and lungs a workout and lowers blood glucose. Aim for 30 minutes at least 5 days a week.

Strength training. This builds muscle and bone mass, keeping you strong and also helping to lower glucose. Using hand weights, kettlebells, or resistance bands, or doing Pilates or yoga all count. Aim to do this 2–3 days per week.

Flexibility. Stretching and yoga help to keep you limber and improve balance, reducing the risk of falling. Stretch after every aerobic session that you do.

Talk to your doctor if you’re thinking of doing anything more than walking, as you may need a stress test. And don’t forget to fit in activity every chance you can. Every little bit truly counts.

Acknowledge your feelings
For many people, getting a diagnosis of diabetes is like being hit in the stomach. It’s a life-altering diagnosis and many things will need to change in your life. Whether you wear your heart on your sleeve or not, keep in mind that it’s normal to have feelings of:

• Anger
• Fear
• Guilt
• Shock
• Loss
• Denial

Try not to bottle up your feelings, though. Ignoring them won’t make them go away. You’re grieving for the life you used to have, so acknowledge that. On the bright side, when you’re ready, think about how having diabetes can be positive: you might view it as an opportunity to lose some weight and become more fit, for example. Now you have the impetus to do so.

Most diabetes teams have a behavioral health specialist on board to help people with diabetes (at any stage in their diabetes) deal with feelings that come up and that threaten to overwhelm. If you’re struggling and talking to family, friends, or coworkers isn’t enough; if you’re unable to care for yourself; or if you’re feeling depressed or anxious about diabetes, don’t hesitate to ask your doctor for a referral to a specialist. There are a lot of ways to help you cope with diabetes, and you don’t have to go it alone.

Find support
Everyone with diabetes needs a support system. For some, their family does the job. For others, it’s their health-care team or a Web-based community, such as Diabetes Self-Management. Think about what would work for you. Hopefully you have a spouse, child, or friend you can talk to and who can help out. It’s important that someone close to you understands what diabetes is and what to do if you, say, have an episode of low blood glucose or are sick. Share information with them. Invite them to a diabetes class or medical appointment. Most people truly want to help.

Finally, keep in mind that you’ll always be learning about your diabetes. There will be new treatments and devices to discover. Your diabetes may change over time, which means that your treatment plan will likely change. Take advantage of Web sites such as this, as well as classes, programs, and lectures in your community. Keep appointments with your health-care team, and don’t forget about regular “tune-ups” with a dietitian and diabetes educator. Continue to be a student and you’ll likely be rewarded.

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Jane

Thank you so much for this series. I was diagnosed with Type 2 today. My doctor was not very helpful and seemed to be blaming me although I have only two risk factors (family history and being 48 yrs). I asked about going to a specialist and she poo-pooed it. I will now go back to her next week to insist on a referral to a dietitian, support, etc… I also feel less alone knowing that some of the feelings you describe are normal. Thanks so much!

jim snell

Thank you Amy for such a detailed and documented ideas.

Your series remind me of what I have found most helpful in that it is a combination of the lighthouse to light the way in extreme darkness, the entertainer to provide some comic relief and humanity, the guide to help provide a path through the detail, a salesman/motivator to press and urge the student on as well as excellent Dietary/medical information.

I wish I had the benefit of a website such as DiabetesSelfmanagement and material provided by Bloggers such as yourelf and others at this site 30 years ago and I could have made the necessary changes I made in the last 5 years – 30 years ago and reduced some of the wear and tear rather than waiting till it was life saving and mandatory!

And Yes, the learning is definitely a constant, ongoing and critical.

acampbell

Hi Jane,

I’m so glad this has been helpful for you and I’m heartened to hear that you’ll be advocating for yourself with your doctor. More power to you!

acampbell

Hi Jim,

Thank you for your heartfelt comment!

Phil Hinds

This series should be a permanent link on the Home page. I made it through the tough times back in ’07, but others just give up & deal with it. Thanks for making me go back and remember that I was scared and worried. I honestly forgot how lost I felt. I ain’t scared of nuttin’ til my doc told me I was sick. Yeah boy big time scary.

jim snell

Amy: You mention Joslin.

When I was out reading reports on who spends what
on type 1 and Type 2 Diabetes, I was surprised at the actual excellent efforts and pratical work done by Joslin on Type 2 diabetes as well that they do work both Type 1 and Type 2.

Yes there are those doing great work on Type 1 spending hard dollars and signifigant amounts and bless them.

As always; thank you for your excellent blogs and columns.

Paul G

Thank you for your 4-part series which I just read. “New to Diabetes” for me resulted Pacreatic Cancer surgery which removed 4/5th of my Pancreas. My Endrocronologist spoke 12 words to me…Period! No guidance on what is too low, too high, when to increase or decrease insulin (only to say that on days I take Chemo and my blood sugurs jump to 240 to 270 to “increase before meal insulin from 4 to 5 units.” A1C was never explained to me (mine turned out to be 7.5…what ever that means). A brief visit from one diatician said I should try to keep blood sugars between 90 and 130 and to dake “45 Carbs per day” (Must, not more than, ???)

Bottom line, I will contact diatician, but do you have more basic information you can share or diret me to? Thank you, Paul G

acampbell

Hi Paul,

I’m sorry that your “experience” with diabetes thus far has been less than helpful. There’s certainly a lot to learn about diabetes, and you haven’t received the guidance that you need. Until you meet with a dietitian, here are a few suggestions: First, explore the Diabetes Self-Management Web site, especially the online articles about nutrition and meal planning. I’d also recommend that you visit the American Diabetes Association’s Web site at http://www.diabetes.org and Diabetic Living at http://www.diabeticlivingonline.com. They provide helpful information, as well. Joslin Diabetes Center’s Web site, at http://www.joslin.org, is useful, too. You might also purchase a book called What Do I Eat Now? by Patti Geil and Tami Ross. The book covers eating basics and can give you a good framework. Also, consider looking into diabetes programs or diabetes educators in your community for general diabetes education. Local hospitals often provide these programs.

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